Lipomyelomeningocele
Overview
A lipomyelomeningocele (pronounced lipo-myelo-men-IN-go-seal) is a birth defect of a child’s spine. It is a fatty mass starting under the skin on the child’s back, usually in the middle. The mass extends inward to the spinal canal. It is covered in skin and is usually visible from outside the child’s body. The two biggest problems with lipomyelomeningocele in children are: 1. The spinal cord is stuck (fixed) to the fatty mass 2. The fatty mass puts pressure on the spinal cord
Symptoms
1. The spinal cord is stuck (fixed) to the fatty mass 2. The fatty mass puts pressure on the spinal cord
Prognosis
hey are classified as dorsal, caudal and transitional varieties. Lipomas of the filum terminal form a different category. Lipomyelomeningocele is a subcutaneous fibro-fatty mass that traverses the lumbodorsal fascia, causes a spinal laminar defect, penetrating the dura and attaches and tethers the spinal cord. It is diagnosed by the fatty mass over the spine [Figure 2]. Magnetic resonance imaging (MRI) is diagnostic and also useful in identifying the associated anomalies. Lipomatous tissue will be seen as high signal on T1 weighted images and low signal on T2. Neurological injury may result from tethering of the cord
Treatment
Because this lesion is covered with skin, we don’t do a lipomyelomeningocele repair until a baby is 4 - 8 months old. If the fatty mass is not removed and the spinal cord remains tethered, neurological damage happens over time. Slowly, she will lose sensory and movement function, also called motor function. First, we do a laminectomy. Neurosurgeons remove one or more sides of the back arches of a spinal bone (vertebra). We can then reach the spinal cord or spinal nerve roots that need repair. Next, we remove some of the fatty mass and free up the spinal cord. We close the defect where the fat enters the baby’s spinal canal.